Household Catastrophic Health Expenditures in Selected Townships of Lower Myanmar
Household Catastrophic Health Expenditures in Selected Townships of Lower Myanmar
复制标题
缅甸下游部分乡镇的家庭灾难性健康支出
DOI：
10.2139/ssrn.1867889
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发表时间：
2011
期刊：
影响因子：
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通讯作者：
S. Kongsin
中科院分区：
文献类型：
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作者：
T. Lwin;Jutatip Sillabutra;S. Kongsin
目的：衡量下缅甸仰光省10个乡镇城市和农村地区家庭灾难性卫生支出的程度。方法：2010年由预防与社会医学部对家庭灾难性医疗支出进行描述性研究。最低标准方法用于确定灾难性卫生支出。根据3个定义的阈值水平确定了灾难性医疗支付的发生率和强度，并通过计算集中指数提出了灾难性医疗支付对贫困和富裕家庭的影响。发现：43%的家庭有灾难性的医疗支出，完全是自掏腰包。所有这些支出都与一个或多个家庭成员的治疗费用有关。在10%、20%和30%的灾难性阈值水平下，灾难性医疗支付的发生率分别为9.4%、5.6%和4.2%。在10%、20%和30%阈值水平下，强度分别为5.9%、5.1%和4.6%。在城市地区更为显著，强度分别为8%、7.3%和6.8%。平均正差距（MPG）异常高，在10%、20%和30%的灾难性阈值水平下分别为62.8%、92.5%和112%。家庭灾难性医疗保健支付的发生率和强度的集中度指数和排名加权版本突出了家庭灾难性医疗保健支付负担的程度，无论是贫困家庭还是富裕家庭，并导致更多地集中在贫困家庭。因此，可以得出的结论是，情况较差的家庭更有可能超过支付门槛，而贫困家庭为医疗保健支付的费用更高。建议：总之，在国家一级和区域一级进行发展的努力将需要经济、体制、行政和改革、人力资源开发和减贫方案等。灾难性卫生支出的发生率和明确表达的对优质卫生保健的需求为创新提供了良好的基础；社区似乎已经“准备好”尝试新事物，并且非常愿意提供全力支持。为了减轻城市和农村地区保健服务的财政负担，应使保健服务更加负担得起，特别是对贫困家庭而言。可以通过尽量减少从农村到城市的通勤费用以获得最低限度的基本保健服务来提高负担能力。这可以通过扩大农村保健中心和次级中心提供的保健服务的覆盖面和提高其质量来实现。
Objective: To measure the extent of household catastrophic health expenditures in both urban and rural areas of ten selected townships in Yangon Division of Lower Myanmar. Methods: The descriptive study for household catastrophic health expenditures was conducted by the Department of Preventive and Social Medicine during 2010. The minimum standard approach was used to determine the catastrophic health expenditures. The incidence and intensity of catastrophic health care payments in terms of 3 defined threshold levels were determined and the impact of catastrophic health care payment matters more for poor or rich households by calculating concentration indices was presented. Finding: 43% of households had catastrophic health expenditures that were entirely out of pocket. All these expenditures related to costs of treatment for one or more of their household members. The incidences of catastrophic health care payments was 9.4%, 5.6% and 4.2% of the sample for 10%, 20% and 30% catastrophic threshold levels respectively. The intensities were 5.9%, 5.1% and 4.6% at 10%, 20% and 30% threshold levels, respectively. It was more significant in urban areas where the intensities were 8%, 7.3% and 6.8%.Mean Positive Gaps (MPG) were extra-ordinarily high and results as 62.8%, 92.5% and 112% in 10%, 20% and 30% catastrophic threshold levels respectively. The concentration indices and rank-weighted versions of incidence and intensity of household catastrophic health care payments highlights the extent of household catastrophic health care payments burdens on whether poor households or rich households and resulted as more concentrated among the poor households. Therefore it can be concluded that there is a greater tendency for the worse-off to exceed the payment threshold and that poor households pay more for health care.Recommendation: In conclusion, the attempts to develop at the national level and the regional level, will need economic, institutional, administrative and reforms, human resource development and poverty reduction programs, to name a few. The incidence of catastrophic health expenditures and the clearly voiced need for health care of good quality provide good ground for innovations; the communities seem to be, “ready,” for trying out something new and are quite willing to give full support. In order to reduce the financial burden of health care services both in urban and rural areas, should be made more affordable especially for poor households. Affordability can be increased by minimizing the expenses of commuting from rural to urban for basic minimum health services. This can be achieved by increasing the coverage and promoting the quality of health care services available from rural health centers and sub centers.